Search PubMed⌕ Search

Biomedical subjects

M Scherrer

Publications and source records attributed to M Scherrer.

At least 37 records · Page 2Linked to original sources
PubMed1984

[Pirbuterol and salbutamol aerosol for exercise-induced bronchoconstriction].

Exercise-induced bronchoconstriction was produced in 12 asthmatic patients after a 6 minutes run on a 10% steep treadmill ergometer. FEV1 decreased by 12-73% (average 27%) of the control value measured before the run. The rather severe exercise-induced bronchoconstriction remained constant for 10-20 minutes after the run. 21 minutes after the run two puffs of a bronchodilator (salbutamol 0.2 mg or pirbuterol 0.4 mg) were inhaled in an open randomized cross-over fashion at intervals of 1 to 3 days. Following both bronchodilators FEV1 returned to the control value within 5 minutes. There was no significant difference between the bronchodilating effect of salbutamol versus pirbuterol. Furthermore, no significant differences were observed in pulse rates after inhalation of the two selective beta-2-stimulators. In our trial both pirbuterol and salbutamol seemed to be well tolerated; side effects were not observed for either drug.

Adult↗
PubMed1984

[Bronchial asthma, nasal polyposis and analgesic intolerance (the ASA triad). A successful computer based analysis of free texts].

In the period 1977 to 1980 the case histories were collected of 1731 asthmatics and 3590 non-asthmatics and stored in free text form in a computer data bank. Analyzing the data, 1643 primary asthmatics were selected comprising 537 seasonal and 417 perennial asthmatics. The incidence of nasal polyposis and chronic sinusitis on the one hand, and intolerance to analgesics on the other, was, at 9.5% and 4.5% respectively, higher in asthmatics than in non-asthmatics. In perennial asthmatics the particularly high incidences of 16% and 7.2% were observed for the two symptoms. As expected, the ASA triad (common occurrence of nasal polyposis, intolerance to analgesics and asthma) was found to be particularly frequent in perennial asthma (3.1%). A higher rate of coincidence of nasal polyposis and intolerance to analgesics was found in asthma patients than pure chance would suggest. This association is statistically significant for all asthma subpopulations. The mechanism which leads to the ASA triad is still unknown. Computer-aided analysis of free text information proved of great assistance in this study.

Analgesics↗
PubMed1984

[Normal values of spirometry for the 15- to 20-year-old age group].

In 130 healthy young men and women aged 15 to 20 years, all non-smokers, volume flow curves were recorded during forced expiratory vital capacity measurements. The forced vital capacity (FVC), the forced expiratory volume of 1 sec (FEV1) and the mid-expiratory flow rate (MEF50) were evaluated in order to establish new standard values for normal people in this particular age group. FVC is strongly height and sex dependent. Our new normal values are in good agreement with those of the literature. Our FVC values, however, are in general slightly higher than those of previous authors. MEF50 turns out to be sex independent but height dependent, but not as much as FVC. Our new normal values for MEF50 are in good agreement with those of Knudson et al., though slightly lower. The FEV1/FVC quotient was found to decrease significantly with height from 0.9 to 0.8. This decrease may be due to the increase in lung volume with growth. It could also be due to lung damage caused by atmospheric air pollution in young adults who are still growing.

Adolescent↗
PubMed1982

[Exercise-induced asthma and arterial hypoxemia].

40 young asthmatic patients performed submaximal work on a treadmill ergometer for 6 minutes. In 20 cases the PaO2 was found to be below 77.5 mm Hg (arterial hypoxemia) at the 10th or the 20th minute of post-exercise recovery time. A first subgroup A of 9 asthmatics presented hypoxemia together with a fall of FEV1 below 90% of control at the first to the 20th minute post-exercise recovery phase. A second subgroup B of 11 asthmatics showed hypoxemia with FEV1's higher than 90%, often higher than 100% of the control value. The following features of the recovery period were observed: 1. 10 minutes delay of onset of hypoxemia in relation to the FEV1 drop in group A. 2. Progressive hypoxemia despite a clear return of FEV1 versus the control value during the late recovery phase of group A. 3. Appearance of arterial hypoxemia despite unchanged normal FEV1's in group B. These three observations suggest that there are 2 kinds of post-exercise bronchoconstrictions. The first may be situated in the large bronchi (FEV1-drop), the second in the small peripheral airways (PaO2-drop), from the first to the 20th and from the 20th to the 40th minute respectively after the end of submaximal work load. It is concluded that there must be 2 sequential bronchoconstrictions due to cooling of the airways and these constrictions may guarantee alveolar homeostasis for body temperature and full saturation with water vapour. However, the first barrier in the large airways can be abolished by high blood levels of adrenaline. In such cases the second barrier in the small airways becomes important and may protect the alveoli from cooling and dry air.

Adult↗
PubMed1981

[Protection from exercise-induced asthma after salbutamol (Ventolin) in powder form, inhaled with the Rotahaler].

15 asthmatic patients with exercise-induced asthma proved by a first run of 6 minutes were selected for a second run some days later. Salbutamol powder (0.4 mg) was inhaled from a Rotahaler immediately before the second run. FEV1 decreased to 83 +/- 10%, 75 +/- 9% and 78 +/- 14% at the end, and 10 and 20 minutes after the first run. FEV1 increased to 110 +/- 16%, 110 +/- 15% and 113 +/- 14%, respectively, when salbutamol powder was inhaled from the Rotahaler before the second run (p less than 0.0005). Control values of FEV1 before the two runs were comparable (p less than 0.25). The heart rate increased to 186 +/- 3 per minute during the first run, to 182 +/- 3 after the second run (p less than 0.0025). Bronchodilation by salbutamol was evident in spite of the 6 minutes of exhausting exercise (p less than 0.0125). Furthermore, salbutamol powder partially or totally suppressed exercise-induced bronchoconstriction in 14 out of 15 cases. Powder inhalation of salbutamol from the Rotahaler is recommended as a valuable alternative medication to inhalation from a pocket pressurized metered aerosol device. The Rotahaler offers advantages, e.g. in patients with known exercise-induced asthma before exhausting athletic activity. The absence of fluorohydrocarbons in the airways may be important in such situations.

Adolescent↗
PubMed1981

[Allergic alveolitis as a result of mold on the bedroom wall].

A 23-year-old woman patient became seriously ill with the typical signs and symptoms of allergic alveolitis and with deep hypoxemia during exercise. A broad spectrum of positive precipitating antibodies was found in the serum, mainly against Penicillium casei and Aureobasidium pullulans. Although she was intensively questioned on hobbies and on possible antigens at home and at work, it was only possible to trace an antigen source after a controlled antigen free period away from home in another environment and after a controlled reexposure experiment at home: it proved to be a patch of mould of 0.5 m2 on the bedroom wall. The filaments and the spores of the fungi of the mould were shown directly by microscope. Precipitating antibodies were also present against these fungi. After several antigen-free months (the patient moved into a dry and sunny new apartment) the threatening respiratory failure (severe hypoxemia during exercise) disappeared completely together with the clinical signs and symptoms. Thus, mould on bedroom walls may constitute a threat and should be considered in cases of allergic alveolitis of apparently unknown origin.

Adult↗
PubMed1981

[Accumulation of eosinophils in the nasal secretion in patients with bronchial asthma].

From October 1977 to September 1979 69 out of 500 asthmatic patients were selected in whom case histories, skin tests and IgE blood-levels formed a sub-group with more or less pure allergic asthma and a sub-group with more or less pure intrinsic asthma. All the patients exhibited a large quantity of granulocytes in the bronchial and nasal secretions. Special attention was paid to the contents of eosinophils in the nasal smear and in the bronchial mucus. The intrinsic subgroup had a (non significantly) greater incidence of 100% eosinophils in the bronchial secretion than the allergic sub-group (p less than 0.1). Unexpectedly, the reverse was found in the nasal secretions: only 33% of the intrinsics (9 cases) and as many as 67% of the allergics (28 cases) exhibited 100% eosinophils in the nasal mucus (p less than 0.025). Thus, when discussing the two forms of asthma, allergic and intrinsic, it is always necessary to bear in mind the possible paradoxical behaviour between nasal and bronchial mucus: pure eosinophilia in the lower respiratory tract may often be found concomitantly with pure neutrophilia in the upper respiratory tract, when some of the criteria for intrinsic asthma are fulfilled.

Asthma↗
PubMed1981

[Klinefelter's syndrome associated with precocious puberty due to tumoral secretion of chorionic gonadotropins].

A 8 and a half year-old boy presented with precocious puberty related to a malignant thoracic teratoma. He was also shown to have a Klinefelter syndrome. Precocious puberty related mainly to the liver, intracranial or thoracic tumors is rare. It seems to be exclusively observed in boys. The slight testicular enlargement is the main clinical sign. The contrast between high LH and low FSH levels is the most striking biological data. The diagnosis is proved by plasma HCG, beta-HCG and alpha-foetoprotein determination. Our patient is the third one with Klinefelter syndrome; this this association is certainly not fortuitous.

Child↗
PubMed1980

[Euphyllin retard and "exercise-induced" asthma].

In a double blind crossover experiment the protective effect of theophylline slow-releasing coated tablets (Euphyllin retard) on exercise-induced asthma has been compared with that of a placebo. Sixteen patients with bronchial asthma (mean age 23 years, range 16-49 years) who were selected in a preliminary test exhibited an FEV1 decrease greater than 15% 10 minutes after an exhausting 6 minute run on the treadmill. Euphyllin retard and placebo were given 6 hours before the exercise test. Venous blood was sampled 6 hours prior to and immediately before exercise in order to determine the plasma concentrations of theophylline by a tritium radioimmunoassay method. FEV1 was measured prior to and immediately after exercise, 10 and 20 minutes later and after a final orciprenaline inhalation. A group of 9 patients (group 1) has plasma concentrations of theophylline lower than 6.2 microgram/ml (4.8 +/- 0.9 microgram/ml), and a group of 7 patients (group 2) had concentrations higher than 10.0 microgram/ml (13.8 +/- 3.3 microgram/ml). Compared with placebo, a protective effect of Euphyllin retard could be observed in group 2 only (p < 0.025). In group 1 the asthma protection was indistinguishable form that of placebo. Hence, plasma concentrations higher than 10 microgram/ml appear to be required to protect asthmatics from exercise-induced asthma. Although in some patients an effective concentration can be achieved by the recommended dose of one tablet of Euphyllin retard (350 mg aminophylline) every 12 hours, the importance of measuring plasma concentrations must be emphasized in view of the variable absorption and elimination of theophylline. Side effects may occur at concentrations higher than 15 microgram/ml.

Asthma↗
PubMed1980

[The new anticholinergic bronchospasmolytic oxitropium bromide. Is long lasting protective effect through the night].

Oxitropium bromide (Ba 253, Boehringer, Ingelheim) is a scopolamine-like atropine derivate with a mode of action approximating to that of ipratropium bromide (Atrovent, Sch 1000). The peak effect and duration of bronchodilatation with oxitropium bromide appears to be better than that of ipratropium bromide. Fifteen patients with a stable chronic bronchial obstruction were investigated in a double blind cross-over study. The obstruction was partially reversible by beta-stimulation. The patients inhaled 0.2 mg oxitropium bromide or placebo at 9.30 p.m. after two controls of FEV1 at 9 p.m. and 9.15 p.m. We re-examined the patients at 7 a.m. and 7.15 a.m. the following day and observed a significant parasympathetic additional obstruction under placebo, whereas, under the medication with oxitropium bromide overnight, significant bronchodilation was observable. When 0.2 mg oxitropium bromide was given at 7.30 a.m. to all patients, those pretreated with placebo showed significantly better bronchodilation than those pretreated with oxitropium bromide. It is concluded that oxitropium bromide is a long-acting (10 hours) overnight bronchodilator. The bronchodilation is probably due to prolonged parasympathicolysis in the airways.

Adult↗
PubMed1980

[Problems of indication and execution of long-term steroid therapy in advanced disabling bronchial asthma].

In the management of severe chronic asthma, extensive avoidance of known precipitating factors and optimum betastimulation supported by theophylline have pride of place. In combination with sodium cromoglycate they sufficiently relieve symptoms and lung function disturbances in most cases of adult extrinsic allergic asthma. The cases with chronic disabling intrinsic asthma need, in our experience, additional long-term use of corticosteroids. The intrinsic type (late onset, severe perennial course, aspirin intolerance, nasal polyps) is in many cases recognised only with difficulty. Detailed history-taking, reversibility of the lung function disturbances and eosinophilia in the sputum may in general differentiate it from chronic obstructive bronchitis and extrinsic asthma. The aim of the long-term use of steroids in asthma is to achieve the best effect with minimal risk. In this respect the following treatment schedule has proved its worth: daily administration of prednisone in a single morning dose, beginning with high doses of 40 to 50 mg with rapid reduction by 5 to 10 mg every 4 days to a dose of 15 mg, then gradual withdrawal in steps of 1 mg at longer and longer intervals with becotide support to achieve a daily maintenance dose of 2 to 6 mg prednisone or complete withdrawal. The response to the treatment under discussion is often excellent and the dangerous side effects are low. However, too rapid reduction of cortisone inhibits the success of this treatment plan. High doses of steroids over a long time (more than 10 mg prednisone daily), prescriptions in daily divided doses, depot administrations, self-medication, and repeated high pushes are the most common causes of the dangerous cortisone side effects and are therefore to be avoided.

Adrenal Cortex Hormones↗
PubMed1979

[Protection from exertion-induced bronchial asthma with disodium cromoglycate (DSCG) (cromolyn, lomudal, intal) and with ketotifen (zaditen). Doubly crossed double-blind study ].

16 cooperative asthmatic patients with exercise-induced asthma (with more than 15% decrease in FEV1 after strenuous work on a treadmill with 10% upward; pulse rates over 180 per minute during the work-phase) were selected to take part in a double-blind crossover trial. The 8 women and 8 men, with ages ranging from 15 to 57 years (mean 25) underwent 4 exercise tests. The effects on exercise-induced asthma of 20 mg disodium cromoglycate (DSCG) inhaled with a spinhaler 30 minutes before exercise were compared to 2 mg of ketotifen taken orally 3 hours before exercise, and likewise DSCG was compared to a placebo powder inhaled with a spinhaler, and ketotifen with placebo tablets. The whole study lasted from January to March. Ten minutes after exercise the following changes in FEV1 (in percent of control value measured before exercise) were seen: after inhalation of a placebo powder the FEV1 decreased to 66% with an almost equal decrease after taking placebo tablets (67%) (0.45 greater than p greater than 0.40) whereas, in comparison, the decrease in FEV1 after DSCG (84%) is smaller than that after inhalation of a placebo powder (66%) (p less than 0.0025). In contrast to these results was the equal decrease in FEV1 after ketotifen (70%) (0.35 greater than p greater than 0.30) and placebo tablets (67%). Although a relatively high chosen dosage of ketotifen was given, it does not seem capable of inhibiting mediator release from the bronchial mast-cells as DSCG does. It is concluded that ketotifen given orally 3 hours before the exercise test is not effective against exercise-induced asthma.

Adolescent↗
PubMed1979

[Cross-over double-blind study using neophylline oral (proxyphylline and diprophylline) in bronchial asthma].

In a double-blind crossover trial 16 asthmatic patients were given placebo or 4 or 8 tablets of Neophyllin (each tablet containing 56 mg proxyphylline and 84 mg diprophylline) on two consecutive days. Very slight bronchodilatation independent of the oral dose and plasma level was observed 90 minutes after taking Neophyllin. However, when a betastimulator was inhaled (0.5 mg salbutamol) prior to taking 8 tablets of Neophyllin, surprisingly marked Neophyllin-induced bronchodilatation was observed after 60 and 90 minutes (p less than 0.05 and p less than 0.025). This bronchodilatation was about half that with 4 slow release coated tablets of Neo-Biphyllin (75 mg teophylline in each tablet). When Neophyllin was taken only proxyphylline caused bronchodilatation (no correlation between plasma diprophylline levels and bronchodilatation). The threshold value of plasma proxyphylline was about 13 microgram/ml plasma. Below this level proxyphylline is ineffective (likewise no correlation between plasma proxyphylline levels and bronchodilatation). An oral dose of about 600 mg proxyphylline (in Neophyllin) is needed to reach an effective plasma level within 90 minutes.

Administration, Oral↗